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Ten-Year and Beyond Follow-up After Treatment With Highly Purified Liquid-Injectable Silicone for HIV-Associated Facial Lipoatrophy

A Report of 164 Patients

Jones, Derek H. MD*; Carruthers, Alastair MD; Brody, Harold J. MD; Black, Jeanette M. MD*; Humphrey, Shannon MD; Carruthers, Jean MD§; Wesley, Naissan O. MD*; Minokadeh, Ardalan MD, PhD*

doi: 10.1097/DSS.0000000000001889
Original Article
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BACKGROUND Highly purified liquid-injectable silicone (LIS) has been established as a permanent agent for off-label correction of HIV-associated facial lipoatrophy (HIV-FLA). However, controversy exists about long-term safety.

OBJECTIVE To establish the safety and efficacy at 10 years or greater of LIS for HIV-FLA.

METHODS Patients from 3 practices with 10-year or greater in-person office follow-up were analyzed to determine the number of LIS treatments and total volume required to achieve optimal correction. The nature of any treated adverse events was noted.

RESULTS One hundred sixty-four patients had 10-year or greater in-office follow-up. All subjects maintained long-term correction with an average of 9 treatments, average of 1.56 mL per treatment, and an average total of 14.1 mL. Two patients had severe adverse events manifesting as temporary facial edema. Four patients experienced mild-to-moderate excess fibroplasia presenting as perceived overcorrection, and 6 patients had nondisfiguring subcutaneous firmness. All adverse events were successfully treatable, mostly with intralesional 5-fluorouracil and triamcinolone.

CONCLUSION Liquid-injectable silicone is an effective long-term treatment option for HIV-FLA. When injected in small quantities with the microdroplet serial puncture technique at monthly or greater intervals, optimal correction appears durable for more than 10 years. Adverse events consisted mostly of excess fibroplasia and were treatable.

*Skin Care and Laser Physicians of Beverly Hills, Los Angeles, California;

Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada;

Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia;

§Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada

Address correspondence and reprint requests to: Ardalan Minokadeh, MD, PhD, 9201 W. Sunset Boulevard, Suite 602, Los Angeles, CA 90069, or e-mail: ardalan.minokadeh@gmail.com

D.H. Jones is an investigator, consultant, and speaker for Allergan, Galderma Aesthetics, Merz North America, Inc., and Revance Therapeutics. A. Carruthers is a consultant and researcher for Allergan, Alphaeon, Merz Pharmaceuticals, and Revance Therapeutics. H.J. Brody has indicated no significant interest with commercial supporters. J.M. Black is an investigator and consultant for Allergan, Galderma Aesthetics, Merz North America, Inc., and Revance Therapeutics. S. Humphrey is a consultant, speaker, and/or investigator for Allergan, Evolus, Galderma, Merz, and Revance. J. Carruthers is a consultant and researcher for Allergan, Alphaeon, Merz Pharmaceuticals, and Revance Therapeutics. N. Wesley is an investigator and consultant for Allergan, Merz North America, Inc., Galderma, and an investigator for Revance Therapeutics. A. Minokadeh is an investigator for Allergan and Revance Therapeutics.

© 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
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